J Korean Ophthalmol Soc.  2002 Apr;43(4):707-713.

Ocular Findings in Children with Ocular Myasthenia Gravis

• Kim JH
• Hwang JM
• Hwang YS
• Kim KJ
• Chae J

Abstract

PURPOSE: In order to make an accurate diagnosis, we investigated clinical manifestations and ocular findings in children with ocular myasthenia gravis that can be easily misdiagnosed.
METHODS
The medical records of 7 boys and 18 girls under the age of 15 years with ocular myasthenia gravis were reviewed retrospectively. The mean follow-up period was 37 months.
RESULTS
The mean age at onset was 37 months. Ptosis was found in 22 patients(88%), strabismus in 21 patients(84%) and amblyopia in 5 patients(20%). Exotropia combined with vertical heterotropia was the most frequent type of strabismus. Ocular motility abnormality was found in 17 patients(68%). The limitation of supraduction or infraduction was most frequently observed. The manifestations of strabismus and ocular motility abnormality were variable and frequently changed during follow-up period. Prednisolone was used more often than pyridostigmine as a maintenance therapy. Ptosis was more responsive to drug therapy than strabismus.
CONCLUSIONS
The main ocular findings in ocular myasthenic children were ptosis and exotropia that was not commonly found in Caucasian children. Vertical heterotropia as well as ptosis were commonly accompanied with the horizontal heterotropia. The type and angle of strabismus as well as ocular motility in duction/version were variable during follow-up period

Keyword

Children; Ocular myasthenia gravis; Ocular motility abnormality; Ptosis; Strabismus

MeSH Terms

Amblyopia
Child*
Diagnosis
Drug Therapy
Exotropia
Female
Follow-Up Studies
Humans
Medical Records
Myasthenia Gravis*
Prednisolone
Pyridostigmine Bromide
Retrospective Studies
Strabismus
Prednisolone
Pyridostigmine Bromide